Browsing by Author "Soto, Mauricio"
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- ItemA cost-effectiveness evaluation of a home visit program for adolescent mothers(SAGE PUBLICATIONS LTD, 2009) Aracena, Marcela; Krause, Mariane; Perez, Carola; Jesus Mendez, Maria; Salvatierra, Loreto; Soto, Mauricio; Pantoja, Tomas; Navarro, Sandra; Salinas, Alejandra; Farah, Claudio; Altimir, CarolinaA home visit intervention program for adolescents throughout their pregnancy and during the early stages of motherhood was evaluated. The participants (N = 90) were part of a larger group of adolescents treated in two health centers in a poor neighborhood in Santiago, Chile. The program was carried out by volunteer community health monitors and evaluated through an experimental, randomized, controlled clinical trial. Cost-effectiveness was examined in comparison with standard health care. Results show higher scores for the intervention group on the mothers' mental health and nutritional state, as well as on the children's levels of linguistic development.
- ItemAssociation between demographic, clinical characteristics and severe complications by SARS-CoV-2 infection in a community-based healthcare network in Chile(2024) Leniz Martelli, Javiera; Hernández Jaña, Sam Steven; Soto Durán, Mauricio Javier; Soto, Mauricio; Arenas, Eduardo; Margozzini Maira, Paula Andrea; Suárez, Francisco; Capurro, Daniel; Rojas Villar, María Paulina; Bambs Sandoval, Claudia ElenaBackground Most of the evidence on risk factors for COVID-19 complications comes from North America or Europe with very little research from Latin-America. We aimed to evaluate the association between sociodemographic, clinical factors and the risk of COVID-19 complications among adults in Chile, the fifth Latin-American country with more COVID-19 reported cases since de beginning of the Pandemic. Methods A retrospective population-based cohort study using data from electronic health records from a large Primary Care Network, linked to national hospital, immunization, Covid-19 PCR surveillance, mortality and birth records. We included people 18+ years old enrolled in the Primary Care Network between 1st January 2020 and 31st December 2021. Using Multivariate Cox proportional hazard models, we evaluate the association between sociodemographic, clinical characteristics with three COVID-19 complications: (1) a hospital admission, (2) an ICU admission, and (3) death due to a COVID-19 infection that occurred between the 1st January 2020 and the 31st December 2021. Results 44,674 people were included. The mean age was 44.30 (sd 17.31), 55.6% were female, 15.9% had a type of healthcare insurance for people from the lowest category of income, 11.6% and 9.4% had a record of hypertension or diabetes mellitus diagnosis. Among the 44,674 people, 455 (1.02%) had a hospital admission due to a COVID-19 infection and 216(0.48%) of them also had an ICU admission. Among the 44,674 people,148(0.33%) died due to COVID-19 infection. Older age and male sex were consistently associated with a higher risk of the three COVID-19 complications. Hypertension and diabetes were associated with a higher risk of a hospital admission and death, but not with an ICU admissions due to COVID-19 infection. Having two or more COVID-19 vaccine doses compared with no doses was associated with a lower risk of any hospital admission (HR 0.81; 95% CI 0.77–0.84), an ICU admission (HR 0.60; 95% CI 0.57–0.63) and death (HR 0.50; 95% CI 0.46–0.54). Pregnant or puerperal women were more likely to be admitted to hospital (HR 2.89; 95% CI 1.41–5.89) or ICU (HR 3.04; 95% CI 1.01–9.14). Conclusions Sociodemographic and clinical factors associated with COVID-19 complications such as age, sex and pre-existing conditions were comparable to those reported in similar studies from higher-income countries, and can be used to predict severity in COVID-19 patients.
- ItemInformática biomédica(SOC MEDICA SANTIAGO, 2011) Capurro, Daniel; Soto, Mauricio; Vivent, Macarena; Lopetegui, Marcelo; Herskovic, Jorge R.Biomedical Informatics is a new discipline that arose from the need to incorporate information technologies to the generation, storage, distribution and analysis of information in the domain of biomedical sciences. This discipline comprises basic biomedical informatics, and public health informatics. The development of the discipline in Chile has been modest and most projects have originated from the interest of individual people or institutions, without a systematic and coordinated national development. Considering the unique features of health care system of our country, research in the area of biomedical informatics is becoming an imperative. (Rev Med Chile 2011; 139: 1611-1616).
- ItemLong-term Mammography Utilization after an Initial Randomized Intervention Period by all Underserved Chilean Women in the Clinics(2022) Puschel, Klaus; Rioseco, Andrea; Soto, Gabriela; Palominos, Mario; Leon, Augusto; Soto, Mauricio; Thompson, BetiSimple Summary Chile has one of the highest rates of breast cancer in Latin America. In Chile, underserved women have lower rates of mammography screening than their medium-to-high-level counterparts and higher morbidity and mortality rates of breast cancer. After a successful randomized controlled trial of low-socioeconomic-status women in a primary care clinic, we used the RE-AIM (Reach, Effectiveness, Adoption, Maintenance) framework to establish the long-term effects of that intervention. After ten years, women at the low-SES intervention clinic continued to show higher mammography rates compared to women at middle-SES clinics; further, these results continued to be above the national rates for low-socioeconomic-status peers. The RE-AIM framework indicates some of the factors that may have contributed to this successful long-term effect among marginalized women in Chile. Chile has one of the highest rates of breast cancer in Latin America. Mammography rates among women, especially those of low socioeconomic status (SES), are thought to contribute to high breast cancer morbidity and mortality. A successful randomized controlled trial among women aged 50 to 70 in a low-SES primary care clinic in Chile led to a significant increase in mammography screening rates in a two-year intervention trial. This study assesses the sustainability of the intervention after ten years and identifies factors that might have been associated with a long-term effect using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. The mammography rates among women aged 50 to 70 in the low-SES intervention clinic were compared to two populations of women aged 50 to 70 from middle-SES clinics and to national data. Qualitative data were used to answer questions of adoption, implementation, and maintenance, while quantitative data assessed the reach and effectiveness. After ten years, low-SES women at the intervention clinic maintained significantly higher mammography screening rates vs. middle-SES women at the comparison clinics (36.2% vs. 30.1% and 19.4% p < 0.0001). Women of a low SES at the intervention clinic also had significantly higher screening rates compared to women of a low SES at a national level (44.2% vs. 34.2% p < 0.0001). RE-AIM factors contributed to understanding the long-term difference in rates. Mailed contact, outreach interventions, and the integration of health promoters as part of the Community Advisory Board were important factors associated with the effects observed. This study provides information on factors that could contribute to reducing the social gap on breast cancer screening.
- ItemMixed-methods evaluation of the initial implementation of advanced home visits in Chile(2022) García-Huidobro Munita, Diego Nicolás; Vergés, Álvaro; Basualto, Patricia; Calvo Miranda, Carlos; Boetto Puebla, Carolina; Soto, Mauricio; Kopplin Ibáñez, Erika Blanca; Martínez Pérez, Mayra Alicia; Aracena Álvarez, MarcelaHome visiting programs are evidence-based interventions that have a myriad outcomes for mothers and newborns. Chile offers these services as part of the Chile Crece Contigo, a nationwide program. However, implementing home visiting programs in community settings is difficult. In this study, we report clinic, provider, and participant engagement with the implementation of advanced home visits (ViDAs) in Chilean primary care clinics. ViDAs include a high number of visits, external supervision, and the use of technology. In this study, qualitative and quantitative data were collected to assess the initial implementation of the home visiting strategy. Qualitative data consisted of individual interviews and focus groups with directors of city health departments, clinic managers, and providers conducting home visits. Quantitative data included clinic, provider, and participant recruitment. City health departments were approached to authorize the participation of primary care clinics in the ViDAs program. Then, clinic directors were invited to approve the implementation of the home visiting program at their health centers. In total, 16 clinics, 42 practitioners, and 185 participants were recruited. A large amount of resources was needed to recruit clinics, providers, and participants. The intervention had low acceptability, low adoption, and a high implementation cost. Initial program implementation experienced several challenges. Identified facilitators and barriers both highlighted the need for community engagement at all levels for the successful implementation of an innovation in Chilean primary care clinics. In addition, this article provides recommendations for practitioners and researchers regarding the conduct of research in community-based settings.
- ItemPerceived importance and interest in research by Chilean primary care providers(2023) García-Huidobro Munita, Diego Nicolás; Aracena Álvarez, Marcela; Bravo Valenzuela, Paulina Fabiola; González, Karla; Soto, Mauricio; von Borries, Pamela; Sapag, Jaime C.Background: Primary care providers (PCPs) are relevant stakeholders for primary care research (PCR). Objective: We report the perceived importance and interest in PCR of a national sample of Chilean PCPs. Methods: We conducted a cross-sectional study targeting Chilean PCPs. An electronic survey assessing perceived relevance of PCR, research training and experience, training interests, and demographics was disseminated through emails and WhatsApp messages. Descriptive statistics were used to summarize data. Logistic regression models were used to estimate adjusted probabilities and 95% confidence intervals for high interest in PCR, high interest in using research methods, and high interest in receiving research training, and predictors of these outcomes. Results: A total of 387 providers completed the online survey. Only 26.4% of PCPs had research experience as a principal or co-investigator. However, most clinicians perceived PCR as very important (92.5%) and were interested in using research methods (90.7%) and receiving training (94.3%). There were no statistically significant differences in these perceptions between provider’s discipline, role, sex, age, and geographical location after adjusting for covariates. Conclusions: Despite few Chilean PCPs have research training, a large majority perceive it as important, are interested in using it in their practice and would like to receive training.